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Cytokine response in cerebrospinal fluid from preterm infants with posthaemorrhagic ventricular dilatation
Author(s) -
Sävman K,
Blennow M,
Hagberg H,
Tarkowski E,
Thoresen M,
Whitelaw A
Publication year - 2002
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2002.tb02834.x
Subject(s) - medicine , proinflammatory cytokine , cerebrospinal fluid , white matter , cytokine , gastroenterology , inflammation , magnetic resonance imaging , radiology
Aim : Posthaemorrhagic ventricular dilatation (PHVD) is closely associated with white matter damage and neurological disability in the preterm infant. Proinflammatory cytokines have been implicated in the pathogenesis of white matter injury and subsequent cerebral palsy. The aim of this study was to determine the levels of proinflammatory cytokines in cerebrospinal fluid (CSF) from preterm infants with PHVD and to correlate the levels to white matter damage and neurodevelopmental outcome. Methods : CSF samples were obtained from 24 preterm infants with expanding PHVD and 19 preterm infants with normal ultrasound. Tumour necrosis factor‐α (TNF‐α), interleukin‐β (IL‐1β), interleukin‐8 (IL‐8) and interferon‐γ (IFN‐γ) in CSF were measured by enzyme‐linked immunosorbent assay, and IL‐6 was measured by bioassay. Results : The concentrations of TNF‐α, IL‐1β, IL‐6 and IL‐8 were significantly elevated in CSF from infants with PHVD. TNF‐α was detected in 43% of PHVD infants and 11% of controls ( p = 0.04). IL‐1β was detected in 67% of PHVD infants and 0% of controls ( p > 0.0001). The concentrations of IL‐6 were 368 (145–460) pg ml ‐1 in the PHVD group and 30 (25–41) pg ml ‐1 in the control group ( p > 0.0001), and those of IL‐8 were 3000 (1620–3400) pg ml ‐1 in the PHVD group and 35 (0–230) pg ml ‐1 in the control group ( p > 0.0001). Cytokine concentrations did not correlate with white matter lesions on ultrasound, shunt dependence or neurological outcome within the PHVD group. Conclusion : There was an intense and prolonged inflammatory reaction in CSF from preterm infants with PHVD and a high risk for subsequent white matter injury and permanent neurological impairment.